hands and feet pealing and toenails falling off.

My three year old's son hands and feet where pealing for about a week. As they pealed another layer of skin was underneath. It wasn't red or painful. After the pealing stopped i noticed that both of his big toenails started coming lose at the base. He doesn't act like anything bothers him. He also has little bumps all over the bottom of his legs and a few on other parts of his body, i thought it was chigger bites, but now i'm not sure if it has something to do with this. Please help me i'm getting worried.

[Bhupinder Kaur, MD]

Hello,
For such peeling of nails and skin, fungal infection should be ruled out. Onycholysis is characterized by a spontaneous separation of the nail plate. It can be due to dermatological causes, systemic causes, neoplastic diseases and biologic causes.

Try avoiding trauma to the nail, contact with contact irritants and moisture and keep your nail shirt. Topical antifungals and steroids may be needed. Severe cases may need oral antifungals and steroid injections.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.